Autophagy and Inflammasome in Obesity: Effect of Weight Loss and Potential Therapeutic Implications

Role of Autophagy and Inflammasome in the Pathophysiology of Obesity: Effect of Weight Loss and Potential Therapeutic Implications

The main aim of this project is to determine the implication of autophagy and inflammasome in the pathogenesis of obesity and related comorbidities, and to explore in depth the mechanisms associated with the activation of immune cells leading early stages of the atherosclerotic process and metabolic disease. The hypothesis of the present study is that weight loss mediated by Roux-en-Y gastric bypass (RYGB) improves the protein expression of markers of autophagy and inflammation within immune cells. Moreover, the investigators will explore the association of these mechanisms with the mitochondrial function and dynamics, Endoplasmic Reticulum (ER) stress an intracellular nutritional status of leukocytes (measured by fluorescence microscopy and western blot). Further, the potential relationship between changes in the mentioned intracellular pathways and systemic pathological mechanisms including oxidative stress, inflammation and glucose and lipid metabolism will be explored. Hence, serum carbonylated proteins, myeloperoxidase (MPO) levels, antioxidant enzymatic activities including SOD (Superoxide dismutase) and catalase, circulating cytokines, and glucose and lipid metabolism parameters will be evaluated in a cohort of obese subjects before and 12 months after RYGB intervention.

Study Overview

• Status: Completed
• Conditions: Obesity
• Intervention / Treatment: Procedure: Roux-en-Y gastric bypass

• Study Type: Observational
• Enrollment (Actual): 45

Contacts and Locations

Study Locations

• Spain
  • Valencia, Spain, 46017
    • Hospital Universitario Doctor Peset

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Subjects with obesity prescribed bariatric surgery to treat their obesity and related comorbidities

Description

Inclusion Criteria:

• Body Mass Index (BMI) ≥ 30 kg/m^2
• duration of obesity over 5 years

Exclusion Criteria:

• history of drug abuse
• pregnancy or lactation
• neoplastic disease
• severe renal/hepatic disease
• history of cardiovascular disease
• chronic inflammatory disease
• secondary cause for obesity (hypothyroidism, Cushing's syndrome)

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Obese; Obese patients undergoing Roux-en-Y gastric bypass

Procedure: Roux-en-Y gastric bypass; Gastric bypass, also called Roux-en-Y gastric bypass, is a type of weight-loss surgery that involves creating a small pouch from the stomach and connecting the newly created pouch directly to the small intestine. After gastric bypass, swallowed food will go into this small pouch of stomach and then directly into the small intestine, thereby bypassing most of your stomach and the first section of your small intestine. Gastric bypass is one of the most commonly performed types of bariatric surgery. Gastric bypass is done when diet and exercise haven't worked or when you have serious health problems because of your weight.; Other Names: RYGB

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in the protein expression of autophagy markers in leukocytes 12 months after the RYGB intervention	Relative expression of intracellular proteins related autophagy/mitophagy mechanisms (Beclin 1, ATG5, LC3II/I, NRB1, PINK1, MIEAP) assessed by western blot and normalized to the loading control protein.	12 months
Changes in the relative protein expression of inflammatory mediators in leukocytes 12 months after the RYGB intervention	Relative expression of intracellular proteins related to inflammatory pathways (MCP1, NF-kB) assessed by western blot and normalized to the loading control protein.	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in the protein expression of markers of mitochondrial dynamics and function in leukocytes 12 months after the RYGB intervention.	Relative expression of proteins related to mitochondrial dynamics and function (OPA1, FIS1, MFN1, DRP1, MFN2, OXPHOS Complex, MTTFA, PGC1α, NRF1, BNIP3) assessed by western blot and normalized to the loading control protein. Changes in mitochondrial membrane potential of leukocytes after the intervention assessed by fluorescence dye TMRM.	12 months
Changes in the protein expression of markers of nutrient sensing and ER stress in leukocytes 12 months after the RYGB intervention.	Relative expression of proteins related to nutritional status, metabolism and Endoplasmic Reticulum (ER) stress (AMPK, SIRT1, ATF6, CHOP) assessed by western blot and normalized to the loading control protein.	12 months
Changes in superoxide production 12 months after the RYGB intervention.	Evaluation of superoxide production in leukocytes by means of fluorescence dye (Relative Fluorescence Units) as contributor to pro-oxidant processes.	12 months
Changes in serum MPO levels 12 months after the RYGB intervention.	Evaluation of serum levels of the prooxidant MPO by immunoassay ELISA (ng/mL) as contributor to pro-oxidant and pro-inflammatory processes.	12 months
Changes in protein carbonylation in serum 12 months after the RYGB intervention.	Evaluation of carbonyl groups in serum proteins by means of immunoassay ELISA (nmol/mg protein) as a marker of systemic oxidative damage.	12 months
Changes in serum SOD enzymatic activity 12 months after the RYGB intervention.	Evaluation of SOD enzymatic activity in serum (nmol/min/mL) as part of the systemic antioxidant defense system.	12 months
Changes in serum catalase enzymatic activity 12 months after the RYGB intervention.	Evaluation of catalase enzymatic activity in serum (nmol/min/mL) as part of the systemic antioxidant defense system.	12 months
Effect of the RYGB on body weight	Changes in the body weight (kg) of patients 12 months after the RYGB intervention determined with an electronic scale	12 months
Effect of the RYGB on Body Mass Index (BMI)	Changes in the BMI (kg/m^2) of patients 12 months after the RYGB intervention, measure by the formula: weight (kg) / [height (m)]^2	12 months
Effect of the RYGB on blood pressure	Changes in Systolic/Diastolic Blood Pressure levels (SBP/DBP) (mmHg) measured with a sphygmomanometer	12 months
Effect of the RYGB on fasting Glucose levels	Changes in fasting Glucose (mg/dL) of patients 12 months after the RYGB intervention, as a marker of glucose metabolism	12 months
Effect of the RYGB on fasting Insulin levels	Changes in fasting Insulin (μU/mL) of patients 12 months after the RYGB intervention, as a marker of glucose metabolism	12 months
Effect of the RYGB on Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) Index	Changes in HOMA-IR Index of patients 12 months after the RYGB intervention, measured with the formula: [Fasting Glucose (mg/dL) x Fasting Insulin (μU/mL)]/405, as a marker of glucose metabolism	12 months
Effect of the RYGB on glycated hemoglobin (HbA1c)	Changes in HbA1c (%) of patients 12 months after the RYGB intervention, as a marker of glucose metabolism	12 months
Effect of the RYGB on Total Cholesterol (TC)	Changes in TC (mg/dL) of patients 12 months after the RYGB intervention, as a marker of the lipid profile	12 months
Effect of the RYGB on High Density Lipoprotein Cholesterol (HDLc) levels	Changes in HDLc (mg/dL) of patients 12 months after the RYGB intervention, as a marker of the lipid profile	12 months
Effect of the RYGB on Low Density Lipoprotein Cholesterol (LDLc) levels	Changes in LDLc (mg/dL) of patients 12 months after the RYGB intervention, as a marker of the lipid profile	12 months
Effect of the RYGB on Triglyceride (TG) levels	Changes in TG (mg/dL) of patients 12 months after the RYGB intervention, as a marker of the lipid profile	12 months
Effect of the RYGB on high sensitivity C-Reactive Protein (hsCRP) levels	Changes in hsCRP (mg/L) of patients 12 months after the RYGB intervention, as a marker of systemic inflammation	12 months
Effect of the RYGB on Interleukin-6 (IL6) levels	Changes in IL6 (pg/mL) of patients 12 months after the RYGB intervention, as a marker of systemic inflammation	12 months
Effect of the RYGB on Interleukin-1 β (IL1β) levels	Changes in IL1β (pg/mL) of patients 12 months after the RYGB intervention, as a marker of systemic inflammation	12 months
Remission rate for pathologies related to metabolic syndrome 12 months after RYGB intervention	Percentage of cases of remission for hypertension, hyperlipidemia and type 2 diabetes (T2D) after the intervention.	12 months

Collaborators and Investigators

• Sponsor: Milagros Rocha Barajas
• Collaborators: Instituto de Salud Carlos III; Hospital Universitario Doctor Peset
• Investigators: Principal Investigator: Milagros Rocha Barajas, PhD, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2017
• Primary Completion (Actual): December 31, 2019
• Study Completion (Actual): December 31, 2019

Study Registration Dates

• First Submitted: September 16, 2021
• First Submitted That Met QC Criteria: September 27, 2021
• First Posted (Actual): October 8, 2021

Study Record Updates

• Last Update Posted (Actual): October 8, 2021
• Last Update Submitted That Met QC Criteria: September 27, 2021
• Last Verified: September 1, 2021

More Information

Terms related to this study

• Keywords: bariatric surgery; cardiovascular disease; atherosclerosis; autophagy; inflammasome
• Additional Relevant MeSH Terms: Overnutrition; Nutrition Disorders; Overweight; Body Weight; Body Weight Changes; Obesity; Weight Loss
• Other Study ID Numbers: PI16/00301

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No